Abstract
Growing evidence supports the importance of lifestyle and environmental exposures—collectively referred to as the ‘exposome’—for ensuring immune health. In this narrative review, we summarize and discuss the effects of the different exposome components (physical activity, body weight management, diet, sun exposure, stress, sleep and circadian rhythms, pollution, smoking, and gut microbiome) on immune function and inflammation, particularly in the context of the current coronavirus disease 2019 (COVID-19) pandemic. We highlight the potential role of ‘exposome improvements’ in the prevention—or amelioration, once established—of this disease as well as their effect on the response to vaccination. In light of the existing evidence, the promotion of a healthy exposome should be a cornerstone in the prevention and management of the COVID-19 pandemic and other eventual pandemics.
Highlights
After the reemergence of the Severe Acute Respiratory Syndrome (SARS) Coronavirus (SARS-CoV) in 2003, Cheng et al [1] warned of the need to take measures aimed at preventing the possibility that SARS—or other viruses—returning if conditions are fit for their introduction, mutation, amplification, and transmission
In the present narrative review, we aim to summarize the effect of the exposome on inflammation and immune function, with a focus on the potential role of lifestyle changes in the prevention—or amelioration once established— of infectious diseases such as COVID-19, as well as their influence on the efficacy of vaccines
Throughout the COVID-19 pandemic, a variety of lifestyle and environmental exposures, collectively referred to as the exposome, that are known to play a major role in immune health, have been worsened
Summary
After the reemergence of the Severe Acute Respiratory Syndrome (SARS) Coronavirus (SARS-CoV) in 2003, Cheng et al [1] warned (in 2007) of the need to take measures aimed at preventing the possibility that SARS—or other viruses—returning if conditions are fit for their introduction, mutation, amplification, and transmission. The implementation of healthy lifestyles and environmental exposures can still play a key role in the context of the current COVID-19 pandem iocf, potentially contributing to the prevention of new cases or the improvement of the prognosis of infected patients [4,5,6,7,8]. These lifestyle measures will be explained in detail foftetehorinnbsoppotfdaihvdeoosmtfooesi-tolitarrldeliSnewlroitotnsueevyentfwneceurmegte,tcmiatncidaaifviatetnnooutrieeelnoeotdgllnaddnlsytnmo,ti,,tane9poscawfenaoflmalo2dagiontpalnniaieilnsttmeenoog-dgrot-nt3lifuwhamlblatm9urad-fseui3iadmatrnyc[ataatit4fiihgtntiinnmae–yanocdtttg8hiblntoasanry]yle,tt,nm.cieoiacfamifdioTodhlnratcfntuhelhaiisichlinn,dsecoeclny(hustlitsweypemoedf.(smdfrrgrielleirienesie.n.ziuf,vgsgneepiwcshtien.psilth,eehnmuistgtiferetye,tnhrdhfmiialpuoMgoezveelsriinteMttmnympehptgwsoodgcay,eeeeifhiitrvnadtnbtstnfoaseegelioseepbstuegrrreworelrnsremtreraeepychtsresngsaicci,ieava,nnabuehwnalespggalsolenaeesaitnosaltplsrsdrrloerlon,edayoebdcpnpgatrsipdeithevguoasethitetoylehellr)aheyaxstisnentn)darpptihsicsdttolihm,pc,haaatnleraoehitlsagpenncnn,xtytasoreoodpsttmscsodmromlgitovisacigiebis,pveavconteuuammrliahoktntotrdhriaeyioeeidndene,cercnrdutitrtgrsacnatoiot.cvvaiogrnetlawenioiofIxtufnensniyrtipcdmntvhtoic,rohonttiiemoioahnnsrsednopvkuigtngiasSrtnovrirtreinneooseimbirincdddgbgebuate.uiengueintntofinItoasteaidnogencistrslttahdiyo2sl-,, vaarisatbuidliytycionnidmumctuendewreitshpotwnsienss[r9e]v. Our objective is to draw attention to the potential importance of complementary lifestyle-related measures in order to deal with the COVID-19 pandemic and possible future pandemics, which should be implemented along with other established measures such as vaccination and medical treatments
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